Cognitive Evaluation Of Patients With GTCS By LOTCA

Objective To discover the status of transient cognition in patients newly diagnosed idiopathic generalized tonic-clonic seizures(GTCS), and to test the reliability and the validity of LOTCA.Methods Evaluating the cognitive status of peoples attended the research with Loewenstein Occupational Therapy Cognitive Assessment(2nd Edition)from orientation,perception,visuomotor organization,thinking operations etc. The control group chose from 50 health people including doctors,nurses,workers in hospital and relatives of patients etc.,while the patients group from 48 patients who are newly dignosed idiopathic GTCS from the outpatient and inpatient department of The First Affiliated Hospital of Kunming medical college between June in 2009 and March in 2010, according to the standard of intaking and excluding. The time distanced from the last spasms for patients received test at the first time is one month at the most and 5 days at the least. Two weeks later,31 health peoples and 22 patients received the test again using LOTCA. The control and patient groups were divided into different sub-groups in the light of age,education,spasmic frequency,utilizing two-samples t-test,analysis of variance(ANOVA),Wilcoxon rank sum test etc. to dicuss cognitive status of patients newly diagnosed idiopathic generalized tonic-clonic seizures (GTCS) in a short time after paroxysms,and to test the internal consistency,test-retest reliability and the discriminant validity of LOTCA.Results 1.Two-samples t-test shows that there are significant difference referring to 3 items including orientation,thinking operations,attention and concentration,9 sub-items including orientation for place,pegboard construction,reproduction of a puzzle,drawing a clock,categorization, Riska object classification,pictorial sequence,geometrical sequence, logic questions between the control group and patient group (P<0.05);2. Two-samples t-test and ANOVA show that with different age, education between the control and patients group, or different age,education, spasmic frequency among patient sub-groups,there are two items or more of cognition have sharp distinction in statistics(P<0.05);3.Cronbach's Alpha and pearson correlation are above 0.900;4. Wilcoxon rank sum test shows that, between the control and patient group,there are significant difference in the terms of 5 items including pegboard construction, reproduction of a puzzle, Riska object classification, geometrical sequence,logic questions,while the rest of items no statistic difference.Conclusion 1.Patients newly diagnosed idiopathic GTCS suffered from cognitive impairment in the terms of orientation,thinking operations,attention and concentration,visuomotor organization in short time. Especially, there are obvious injury in thinking operations, attention and concentration.2.To compare with the corresponding control group,the patient group with different education or age have sharp cognition injury. In the patient sub-groups, people who are high-level education or older suffered from high-comprehensive cognitive impairment,vice verse, people who are low-level education or younger suffered from low-comprehensive cognitive impairment;3.People with different spasmic frequency have different cognitive impairment. Especially,the frequency above 10 a year resulted in a sharp cognitive impairment;4. The internal consistency,test-retest reliability of LOTCA are high for patients newly diagnosed idiopathic GTCS,and the discriminant validity of LOTCA are high in the terms of 5 items including pegboard construction, reproduction of a puzzle, Riska object classification, geometrical sequence,logic questions.